The bill defines “like-kin” for the purposes of such a placement to be a person
who has a significant relationship with a child or the child's family if that person 1)
prior to the child's placement with the person, had an existing relationship with the
child or child's family that is similar to a familial relationship; 2) during the child's
placement with the person, developed a relationship with the child or child's family
that is similar to a familial relationship; or 3) for an Indian child, is identified by the
child's tribe as kin or like-kin according to tribal tradition, custom or resolution,
code, or law. Under the bill, “like-kin” does not include a current or former foster
parent of a child for placement purposes.
Under current law, a relative other than a parent who is providing care and
maintenance for a child under a court order (kinship care provider) may receive
monthly kinship care payments from DCF or a county department. The bill includes
as kinship care providers first cousins once removed and like-kin persons.
Under current law, for the purposes of permanency planning, a family
permanency team may include like-kin. The current law definition of “like-kin,” for
the purpose of determining the family permanency team, is similar to the definition
of “like-kin” for placement purposes in the bill, except that the current law definition
1) does not exclude a current or former foster parent and 2) does not include
individuals identified by the child's tribe if the child is an Indian child. Under the
bill, the definition of “like-kin” for determining a family permanency team does not
exclude a current or former foster parent but does include individuals identified by
the child's tribe if the child is an Indian child.
Kinship care flexible support
The bill creates flexible support for a kinship care provider. Support provided
under the bill may include additional flexible payments or services to a kinship care
provider who DCF determines qualifies. Under the bill, DCF may promulgate
administrative rules to specify qualifying costs and services and eligibility criteria
for the flexible support.
Foster care and kinship care rates and payments
The bill changes the monthly basic maintenance rates that the state or a county
pays to foster parents certified to provide level one care and to all kinship care
providers, which under current law are $300 per month for a child of any age, to be
the same as the age-based monthly basic maintenance rates paid to foster parents
providing higher than level one care. The bill also increases these age-based
monthly basic maintenance rates by 5 percent. Beginning on January 1, 2024, the
monthly rates are $441 for a child under five years of age, $483 for a child 5 to 11 years
of age, $548 for a child 12 to 14 years of age, and $572 for a child 15 years of age or
over.
The bill provides that, in addition to the monthly rates currently paid to a
kinship care provider, DCF or, with DCF's approval, a county department may make
emergency payments for kinship care to a kinship care provider if any of the
following conditions are met:
1. The governor has declared a state of emergency, or the federal government
has declared a major disaster, that covers the locality of the home of the kinship care
provider (home).
2. This state has received federal funding to be used for child welfare purposes
due to an emergency or disaster declared for the locality of the home.
3. DCF has determined that conditions in this state or in the locality of the
home have resulted in a temporary increase in the costs borne by foster homes and
kinship care providers, including a pandemic or other public health threat, a natural
disaster, or unplanned school closures of five consecutive days or more.
The bill provides that DCF must determine the amount of an emergency
payment based on available funding and may promulgate administrative rules
governing the provision of the payments.
The bill changes the statutes and the administrative code to make kinship care
providers and foster homes certified to provide level one care eligible to receive
exceptional payments to enable siblings or a minor parent and minor children to
reside together and to receive an initial clothing allowance. Under current law, these
payments are only available to foster homes certified to provide higher than level one
care.
Grants for youth services
The bill consolidates certain DCF youth services programs into a new youth
services grant program. Under current law, the following DCF programs provide
youth services: grants for services for homeless and runaway youth, treatment and
services for children who are the victims of sex trafficking, grants for children's
community programs, and the Brighter Futures Initiative. Under the bill, these
programs are consolidated into the youth services grant program, under which DCF
must distribute grants to public agencies, nonprofit corporations, and Indian tribes
to provide programs that accomplish one or more of the following purposes:
1. Increasing youth access to housing.
2. Increasing youth self-sufficiency through employment, education, and
training.
3. Increasing youth social and emotional health by promoting healthy and
stable adult connections, social engagement, and connection with necessary
services.
4. Preventing sex trafficking of children and youth.
5. Providing treatment and services for documented and suspected victims of
child and youth sex trafficking.
6. Preventing and reducing the incidence of youth violence and other
delinquent behavior.
7. Preventing and reducing the incidence of youth alcohol and other drug use
and abuse.
8. Preventing and reducing the incidence of child abuse and neglect.
9. Preventing and reducing the incidence of teen pregnancy.
The bill allocates $500,000 in Temporary Assistance for Needy Families
funding to the grants for youth services that under current law is allocated for the
Brighter Futures Initiative for programs to provide evidence-based programs and
practices for substance abuse prevention to at-risk youth and their families.
Under current law, DHS transfers amounts to DCF for the Brighter Futures
Initiative. Under the bill, DHS transfers those amounts to DCF for the grants for
youth services. The bill maintains a requirement, currently under the Brighter
Futures Initiative, that DCF distribute $55,000 in each fiscal year to Diverse and
Resilient, Inc., to provide youth services as part of the new youth services grant
program.
Youth aids; allocations
Under current law, DCF is required to allocate to counties community youth
and family aids (youth aids) funding. Youth aids funding comes from various state
and federal moneys and is used to pay for state-provided juvenile correctional
services and local delinquency-related and juvenile justice services. The bill updates
the allocation of youth aids funding that is available to counties for the 2023-25 fiscal
biennium.
The bill eliminates a current law provision that allocates some of the youth aids
funding to reimburse counties that are purchasing community supervision services
from DOC for juveniles, and some for alcohol and other drug abuse treatment
programs.
Youth aids; administration
Current law allocates some youth aids for the purchase of juvenile correctional
services, emergencies, provision of community supervision services for juveniles,
and for alcohol and other drug abuse treatment programs. Also, under current law,
DCF may award funding to counties for early intervention services for first offenders
under the community intervention program (CIP).
The bill replaces CIP with the youth justice system improvement program.
Under the bill, DCF may use funding for the youth justice system improvement
program to support diversion programs, to address emergencies related to youth
aids, and to fund other activities required of DCF under youth aids.
Under current law, youth aids funding is allocated to counties on a calendar
year basis. Youth aids funds that are not spent in the calendar year can be carried
forward three ways: 1) DCF may carry forward 5 percent of a county's allocation for
that county for use in the subsequent calendar year; 2) DCF may carry forward
$500,000 or 10 percent of its unspent youth aids funds, whichever is larger, for use
in the subsequent two calendar years; and 3) DCF may carry forward any unspent
emergency funds for use in the subsequent two calendar years.
The bill changes the way that unspent youth aids are carried forward. Under
the bill, DCF may still carry forward 5 percent of a county's allocation for that county
to use in the next calendar year. However, instead of carrying forward $500,000 or
10 percent of its unspent youth aids funds, whichever is larger, for use in the next
two calendar years, under the bill, DCF may transfer 10 percent of unspent youth
aids funds to the appropriation for the youth justice system improvement program.
Children and family services
Under current law, DCF must distribute not more than $101,154,200 in fiscal
year 2021-22 and $101,162,800 in fiscal year 2022-23 to counties for children and
family services. The bill updates those amounts to $101,564,700 in fiscal year
2023-24 and $101,961,600 in fiscal year 2024-25.
Intensive family preservation services
The bill creates new authority for DCF to provide intensive family preservation
services or to provide funding for a county department, a nonprofit or for-profit
corporation, a tribe, or a child welfare agency to provide intensive family
preservation services. The bill defines “intensive family preservation services” to
mean evidence-informed services or support aimed at preventing the removal of
children from the home under the Children's Code or the Juvenile Justice Code,
promoting the safety of children in the home, or serving children who are placed in
out-of-home care or who are involved in the juvenile justice system.
The bill also creates a new GPR appropriation for DCF to provide intensive
family preservation services.
Group care referral clearinghouse
The bill creates new authority for DCF to create, maintain, and require the use
of a group care referral clearinghouse, and to promulgate administrative rules
necessary to accomplish this.
Five-county pilot program for representation of parents in CHIPS
proceedings.
Under current law, a parent is generally not entitled to representation by a
public defender in a proceeding under CHIPS proceeding. However, a pilot program
that began in 2018 requires the state public defender to assign counsel to any
nonpetitioning parent in these cases in Brown, Outagamie, Racine, Kenosha, and
Winnebago Counties. This five-county pilot program is set to expire on June 30,
2023. The bill extends the expiration date of the pilot program to June 30, 2025.
Tribal family services grants and funding for out-of-home-care placements
by tribal courts
Current law uses Indian gaming receipts to fund tribal family service grants
and unexpected or unusually high-cost out-of-home-care placements of Indian
children by tribal courts. The bill appropriates GPR moneys for those purposes as
well.
Grants to support foster parents and children
2017 Wisconsin Act 260 established a one-year pilot program for DCF to
distribute grants to counties, nonprofit organizations, and tribes for the purpose of
supporting foster parents and providing normalcy for children in out-of-home care.
The bill makes the grant program permanent.
Sibling connections scholarships
The bill requires DCF to provide scholarships to adopted children and their
biological siblings who do not reside in the same household to attend programs
together in order to build sibling connections.
Child care partnership grant program
The bill authorizes DCF to establish a grant program to award funding to
businesses that provide or wish to provide child care services for their employees.
The bill allows such a grant to be used to reserve child care placements for local
business employees, pay child care tuition, and other costs related to child care.
Under the bill, a grant recipient must provide at least 25 percent matching funds.
The bill allows DCF to promulgate administrative rules to administer the grant
program, including to determine eligibility for a grant.
Emergency services
Ambulance assessment and certified public expenditures program
The bill creates an appropriation to make payments from the ambulance
service provider trust fund to eligible ambulance service providers as specified under
2021 Wisconsin Act 228. Act 228 implemented an ambulance service provider
assessment on private ambulance service providers for supplemental
reimbursements under the MA program and a supplemental reimbursement under
the MA program to public ambulance service providers through certified public
expenditures. Generally, under the MA program, the state provides its share of the
funding for benefits and the federal government then contributes its designated
share of funding, also known as federal financial participation. Act 228 imposes on
each private ambulance service provider a fee for the privilege of doing business in
this state and establishes an ambulance service provider trust fund for the fees
collected.
The bill also requires DHS to transfer moneys annually from the ambulance
service provider trust fund to cover the administrative costs associated with
administering the ambulance assessment and making supplemental
reimbursements to ambulance providers.
Certification of emergency medical responders
Under current law, no individual may act as an emergency medical responder
unless he or she is certified by DHS as an emergency medical responder. To be
eligible for certification as an emergency medical responder, current law requires an
individual to be at least 18 years of age, to be capable of performing the actions
required of an emergency medical responder, and to have completed an emergency
medical responder course that meets or exceeds the guidelines issued by the federal
National Highway Traffic Safety Administration. The bill requires DHS to certify
individuals as emergency medical responders who complete a certified training
program for emergency medical responders or pass the National Registry of
Emergency Medical Technicians (NREMT) examination for emergency medical
responders without requiring any further examination. However, the bill provides
that any relevant education, training, instruction, or other experience that an
applicant obtained in connection with any military service satisfies the completion
of a certified training program if the applicant demonstrates that the education,
training, instruction, or other experience obtained is substantially equivalent to the
certified course. The bill allows DHS, in consultation with the Emergency Medical
Services Board, to promulgate administrative rules to establish educational
standards for training programs for emergency medical responders and minimum
examination standards for training programs for emergency medical responders.
Further, the bill prohibits emergency medical responders from replacing emergency
medical technicians as members of an ambulance crew unless the emergency
medical responder has passed the NREMT examination for emergency medical
responders.
Epinephrine for ambulances
The bill requires that DHS reimburse ambulance service providers for a set of
two epinephrine auto-injectors or a set of two draw-up epinephrine kits for each
ambulance operating in this state. Under the bill, an ambulance service provider
means an ambulance service provider that is a public agency, volunteer fire
department, or nonprofit corporation. The bill also requires that, on an ongoing
basis, DHS must, upon request, reimburse ambulance service providers for
replacement sets of epinephrine auto-injectors or draw-up epinephrine kits. DHS
may only reimburse ambulance service providers for epinephrine if each ambulance
for which the ambulance service provider is reimbursed is staffed with an emergency
medical services provider who is qualified to administer the epinephrine.
Emergency medical services flex grant
During the 2021-23 fiscal biennium, DHS administered a grant program,
known as the Emergency Medical Services Flex grant program, under which DHS
awarded grants to emergency medical services providers for reasonable operating
expenses related to providing emergency medical services. The EMS Flex grants
were funded with moneys provided under the federal American Rescue Plan Act of
2021.
The bill allows DHS to award grants to emergency medical services providers
for the same purposes as DHS awarded grants under the EMS Flex grant program.
The bill provides GPR funding for this purpose as a continuing appropriation, which
means that any unencumbered balance at the end of a fiscal year does not lapse to
the general fund. In other words, DHS may continue to expend moneys appropriated
for grants to emergency medical services providers until the appropriation is fully
depleted.
Ambulance inspection
Under current law, prior to issuing a registration for an ambulance, DOT must
inspect the ambulance to determine whether it meets requirements for
specifications, medical equipment, supplies, and sanitation.
The bill provides that DHS, rather than DOT, must inspect an ambulance to
determine whether it meets requirements for medical equipment and prohibits DOT
from issuing a registration for an ambulance until DHS has conducted the
inspection. The bill authorizes DHS to promulgate administrative rules to establish
these medical equipment requirements for ambulances.
Health
Complex patient pilot program
The bill requires DHS to form an advisory group to assist with development and
implementation of a complex patient pilot program. Under the bill, the secretary of
health services shall serve as chair of the advisory group, and members must have
clinical, financial, or administrative expertise in government programs, acute care,
or post-acute care. The bill requires the advisory group to develop a request for
proposal from partnership groups that would be designated as participating sites for
the pilot program. Under the bill, only partnership groups that include at least one
hospital and at least one post-acute facility are eligible to participate, but
partnership groups could include more than one hospital or post-acute facility. The
bill requires applicant partnership groups to address certain issues in the
application, including 1) the number of beds that would be set aside in the post-acute
facility; 2) the goals of the partnership during the pilot program and after the pilot
program; 3) the types of complex patients for whom care would be provided; 4)
expertise to successfully implement the proposal; 5) the per diem rate requested to
adequately compensate the hospital or hospitals and the post-acute facility or
facilities; 6) a post-acute bed reserve rate; and 7) anticipated impediments to
successful implementation and how the applicant partnership group intends to
overcome the anticipated impediments.
Under the bill, the advisory group must also determine and recommend to DHS
an amount of the funding budgeted for the pilot program to be reserved for
reconciliation to ensure that participants are held harmless from unanticipated
financial loss. The bill also requires the advisory group to develop a methodology to
evaluate the complex patient pilot program and make recommendations to the
secretary of health services regarding which partnership groups should receive
designation as participating sites for the pilot program. The bill allows DHS to
contract with an independent organization to evaluate the complex patient pilot
program. The advisory group or any independent organization hired to complete the
evaluation of the pilot program must complete and submit to the secretary of health
services an evaluation of the pilot program, including a written report and
recommendations, no later than June 30, 2025.
Funding for opioid antagonists
The bill directs DHS to annually award up to $2,000,000 to entities for the
purchase of opioid antagonists.
Health care provider innovation grants
Under current law, DHS is required to award grants for certain community
programs. The bill allows DHS to distribute up to $15,000,000 in each fiscal year as
grants to health care providers and long-term care providers to implement best
practices and innovative solutions to increase worker recruitment and retention.
Defining lead poisoning or lead exposure
The bill modifies the definition of lead poisoning or lead exposure from a level
of lead in the blood of five or more micrograms per 100 milliliters of blood to 3.5 or
more micrograms per 100 milliliters of blood. The bill also changes the
circumstances under which DHS is required to conduct, or ensure there is conducted,
a lead investigation of a dwelling or premises. Under current law, DHS is required
to conduct, or ensure there is conducted, a lead investigation of a dwelling or
premises when DHS is notified that an occupant of the dwelling or premises who is
under the age of six has an elevated blood lead level, which current law defines as
a level of lead in the blood that is either 1) 20 or more micrograms per 100 milliliters
of blood, as confirmed by one venous blood test; or 2) 15 or more micrograms per 100
milliliters of blood, as confirmed by two venous blood tests that are performed at least
90 days apart. Under the bill, DHS is required to conduct, or ensure there is
conducted, a lead investigation of a dwelling or premises when DHS is notified that
an occupant of the dwelling or premises who is under the age of six has lead poisoning
or lead exposure. The bill also requires that when DHS receives such a notification,
DHS must present official credentials to the owner or occupant of the dwelling or
premises or a representative of the owner and request admission to conduct a lead
investigation of the dwelling or premises. As under current law, if an owner or
occupant refuses to grant admission, DHS may seek a warrant to investigate the
dwelling or premises.
Maternal and infant mortality prevention and response
The bill requires the DHS to do all of the following for the prevention of and
response to maternal and infant mortality, including 1) award grants to community
organizations with the aim of preventing maternal and infant mortality, 2) award
grants to support the expansion of fetal and infant mortality review and maternal
mortality review teams statewide and expand technical assistance and support for
existing fetal and infant mortality review and child death review teams, 3) provide
funding and technical assistance to community-based organizations aimed at
preventing infant morality, and 4) provide funding for grief and bereavement
programming for those impacted by infant loss.
Funding for infant testing programs
Under current law, DHS and the Wisconsin State Laboratory of Hygiene
operate a newborn screening program under which newborn babies are tested for
certain blood disorders, in addition to hearing loss and critical congenital heart
disease. Current law appropriates funding for the program from fees charged for
various costs associated with the program. The bill creates an additional GPR
appropriation to provide funding for the program and various costs associated with
the program.
Personal protective equipment stockpile
The bill provides funding to DHS to establish and maintain a state stockpile of
personal protective equipment.
Grants for tribal long-term care system development
The bill requires DHS to annually allocate up to $5,500,000 to federally
recognized American Indian tribes and bands located in this state for capital
improvements to tribal facilities serving tribal members with long-term care needs
and for improvements and repairs to homes of tribal members with long-term care
needs to enable tribal members to receive long-term care services at home.
Funding for free and charitable clinics
The bill increases from $1,500,000 to $2,000,000 the amount DHS is required
to award in grants to free and charitable clinics each fiscal year.
Grants to free-standing pediatric teaching hospitals
The bill directs DHS to award grants to free-standing pediatric teaching
hospitals to fund programming related to parenting, educational needs of and
supports for chronically ill children, and case management for children with asthma.
The bill specifies that only free-standing pediatric teaching hospitals for which at
least 45 percent of total inpatient days are provided to MA recipients are eligible for
the grant.
Low-value care analysis grant
In each of the 2023-24 and 2024-25 fiscal years, the bill requires DHS to award
a grant of up to $900,000 to an organization for the purpose of conducting a data
analysis of claims under the MA program and under health insurance plans offered
to state employees to identify low-value care. The grant recipient must report its
findings, including any recommendations for providing effective and efficient care,
to DHS and ETF, who must then distribute the grant recipient's findings to certain
health care providers, health care maintenance organizations, and insurance
companies.
